IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

CIVIL / FAMILY DIVISION

)	NO. -FC-
)
Plaintiff	)	CHILD CUSTODY
vs	)
)
)
Defendant	)

AFFIDAVIT OF SERVICE BY MAIL

Pursuant to Pa. R.C.P. 1930.4

I ,	hereby certify that the Complaint for
(Plaintiff’s name)
Custody, Scheduling Order, and blank Criminal Record / Abuse History Verification were mailed
to Defendant by First Class Mail and Certified Mail, Return Receipt Requested, Restricted
Delivery on
(date mailed)
1,	First class mail was
returned
not returned
2.	Certified mail was
accepted
refused
other
(explain)

VERIFICATION

I verify that the statements made in this Affidavit are true and correct. I understand that false statement herein are made subject to the penalties of 18 Pa. C.S.§4904 relating to unsworn falsification to authorities.

______________	________________________

Date	Plaintiff’s Signature

Page 1 of 2

IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

CIVIL / FAMILY DIVISION

)	NO. -FC-
)
Plaintiff	)	CHILD CUSTODY
vs	)
)
)
Defendant	)

AFFIDAVIT OF SERVICE

Attach the Domestic Return Receipt (green post card)

with Defendant’s signature and date of delivery side up.

OR -

Attach the envelope mailed to the Defendant marked “refused.”

EXHIBIT A

Page 2 of 2

Affidavit of Service

Original Process

2/28/2020

IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLANIA

County of Lehigh

2020-04-22

Rachel A Wotring

County of Lehigh